Provider Demographics
NPI:1922257955
Name:MATHEWS PSYCHOLOGICAL SERVICES
Entity type:Organization
Organization Name:MATHEWS PSYCHOLOGICAL SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:LAURA
Authorized Official - Middle Name:LYNNE
Authorized Official - Last Name:MATHEWS
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:317-228-0566
Mailing Address - Street 1:9640 N AUGUSTA DR
Mailing Address - Street 2:SUITE 434
Mailing Address - City:CARMEL
Mailing Address - State:IN
Mailing Address - Zip Code:46032-9600
Mailing Address - Country:US
Mailing Address - Phone:317-228-0566
Mailing Address - Fax:317-228-0514
Practice Address - Street 1:9640 N AUGUSTA DR
Practice Address - Street 2:SUITE 434
Practice Address - City:CARMEL
Practice Address - State:IN
Practice Address - Zip Code:46032-9600
Practice Address - Country:US
Practice Address - Phone:317-228-0566
Practice Address - Fax:317-228-0514
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-09-15
Last Update Date:2008-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN20041985A261QM0850X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health